PCMH Pricing

The following pricing goes into effect for PCMH Recognition on January 11, 2024.

Jump To:

• Single Site Pricing
• Multi-Site Pricing
• Pricing Extra Virtual Review
• Refund Policy
• Partners in Quality Discount

Pricing: Single Site

Single site pricing is for organizations with fewer than three sites seeking recognition, or for organizations with three or more sites that do not meet multi-sites criteria. Practices seeking recognition for the first time pay the initial recognition fee at enrollment. Thereafter, they pay the recognition fee at Annual Reporting. Fees apply to each clinician associated with the sites’s recognition.

Example: The example below will provide you some context as to how pricing is applied. For this example, an organization has 1 sites: a single practice site with 16 clinicians.

The organization pays $7,338 for its Initial Recognition Fee.

The organization pays $2,168 each year during its annual reporting period.

Pricing: Multi-Site

Multi-sites pricing is for practices that:

• Have three or more sites operating under the same legal organization;
• Share an EHR system; AND
• Have at least some of the same policies and procedures.

Sites seeking recognition for the first time pay the recognition fee at enrollment. Thereafter, they pay the recognition fee at their Annual Reporting.

Organizations that bring sites through the multi-entity process pay an organization multi-sites fee of $1,785 during initial recognition, as well as a per clinician fee for each sites. The organization multi-sites fee allows you to bring through as many sites as you want for one year at the multi-sites rate. If you wish to add new sites after that year time frame, you must pay a new multi-sites fee.

Sites seeking recognition for the first time pay the initial recognition fee at enrollment. Thereafter, they pay an Annual Reporting fee each year for their Annual Reporting period. Fees apply to each clinician associated with the sites’s recognition.

Example: The example below will provide you some context as to how pricing is applied. For this example, an organization has 3 practice sites. Site A has 14 clinicians, Site B has 6 clinicians, Site C has 16 clinicians.

The organization pays $10,539 for its Initial Recognition Fee.

The organization pays $5,352 each year during its Annual Reporting period.

Pricing: Extra Virtual Review

Sites that have not achieved recognition after the third check-in or have not completed recognition within the 12-month allotted time frame can purchase an extra Virtual Review. The pricing for the extra review is 50% of the initial per clinician fee paid by the entity. Fees apply to each clinician associated with the entity’s recognition.

Refund Policy

NCQA will refund 80% of the Initial Recognition Fee paid by an entity if the practice cancels their application with NCQA within 45 calendar days of payment. After this time, there is no right to a refund. For refund requests submitted within 5 calendar days of payment, NCQA will refund the Initial Recognition fee in full.  All refund requests must be in writing and should be submitted via My NCQA. There is no right to a refund for any other fees or costs paid to NCQA.

Partners In Quality Discount Pricing

The Partners in Quality discount* is available for both single and multi-entity practices pursuing recognition for the first time. NCQA offers a discount to applicants sponsored by NCQA Partners in Quality (health plans, employers and other organizations that provide resources and services to support practices in pursuit of PCMH transformation).

Entities that use a Partner In Quality discount code receive 20% OFF their initial recognition fee.

To get this discount, request a discount code from your Partners in Quality sponsor organization and apply it when you pay during enrollment.

*Applies to initial recognition fees only.

Reconsideration

The fee for Reconsideration of a Recognition decision is $1,670, per practice site. A practice that would like to initiate the Reconsideration process must pay this fee when it submits its written request.

MAC REVIEW

A fee is charged for a MAC review. MAC reviews will be priced when they are initiated and will be 50% of the current recognition fee for the practice(s) or site(s) being reviewed. The recognition fee is based on the current number of clinicians or sites and the recognition price at the time of the MAC review. This may be the initial recognition fee, the standard survey price, or the full application fee as each is described in the fee schedule for the applicable recognition program.